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I recently read some discussions of ways to eliminate disturbing thoughts. I have treated a number of patients with this problem and have some of my own ideas that could be of help with this problem.

A disturbing thought may begin with something observed in a movie, in real life, or with something heard or read. It is immediately made worse if it induces a reaction.

Here are some examples of such thoughts. I worked with a commercial pilot that was required to sit in the cockpit and do nothing but monitor instruments and watch the skies for other airplanes. His thoughts turned to all sorts of problems like his investments and affording education for his children. It is torture to have to sit and do “nothing” for long periods of time. For some, listening to music helps. Another patient was a nanny that had thoughts of killing the children that she cared for. A man tended to think about all the “silly” things he said to his girlfriends, causing them to reject him. It is pretty normal to have some such thoughts.

Understanding anxiety is the key to dealing with disturbing thoughts. . This is a set of conditions that prepare the body for dealing with attacks; generally running away or fighting. To support these vigorous actions, there is an increase in heart ate, blood pressure, some muscles tense, faster breathing, sweating, etc., all changes necessary to support increased activity. Sometimes this activation occurs when there is no threat, and it can last for days or much longer. When this “fight or flight” preparation is excessive, inappropriate, and lasts for a long time, it is called anxiety. Often there is a circular process that prolongs this reaction. Fearful thoughts stimulate the physical anxiety and the feeling of anxiety leads to fearful thoughts.

It is also helpful here to define thought It is assumed to be some type of brain activity that involves words, feelings, and/or images. Scientists know a little about certain simple thoughts, but complex thinking is not yet understood. Brain actions closely associated with sensations or movements have been studied and are fairly well understood. Some thoughts appear to have a trial-and-error function that precedes difficult decisions. For example, you want to ask your boss for a raise. Your brain will try out different words and approaches and note what “feels” best.

Here are some therapy ideas and methods:
1. Do not fight these thoughts. Allow them to pass through your mind. Accept the fact that certain thoughts may occur for a long time, but usually will gradually have less effect.
2. If bothered by a specific phrase, and other methods don’t work, try repeating the words many times, until they are meaningless. This may take many repetitions.
3. Do a “brief relaxation response” (see below) every time the disturbing thought occurs. This way, the thought will be associated calmness instead of stress.
4. Associate the thought with something pleasant or funny. For example, if you keep thinking about a mistake you made, then associate that with something good that you did.
5. Some people can accomplish these actions by themselves, but many others will need the help of a therapist.

Some people are helped by simply talking about a problem with a therapist. Others will need some physical training like “progressive muscle relaxation” or biofeedback. These physical methods will improve emotional control and will diminish anxiety. A generally healthy method, which can also help with anxiety or stress, is to stretch the major skeletal muscles. Stretching muscles tends to relax them and will also prevent injuries.

A fully licensed Ph.D. behavior therapist is recommended for the best therapy. Psychoanalysis is generally not effective for the problems discussed above. Methods like yoga or meditation include some procedures that are helpful, but include other aspects that may not help. It is best to find a therapist that has precisely what you need, rather than using more “mystical” methods which will be less effective. For very serious cases and medication, a psychiatrist might be required. If possible, it is best to start with a Ph.D psychologist instead of psychiatric drugs.

The “brief relaxation response” mentioned above, consists of the following. The goal is to relax all major muscles of the body, and to try and make breathing as peaceful as possible. Muscles can be relaxed by (1) tensing and loosening, (2) stretching them, and/or (3) by shaking (example: let your arms hang down very loosely and then shake them). Many patients benefit from relaxation tapeswith instructions, that are available on the Internet (search “muscle relaxation tapes”). Here is a good example:

You can also find relaxing music. My version of a brief relaxation response takes about 10 to 20 seconds after training. Begin by inhaling slowly and deeply. Then, exhale slowly and as you do this, let your whole body go limp. The “limp” part requires some practice, with or without a therapist. You can add a quick neck or scalp massage, and be sure to check tension in the back and calf muscles.

Here is a possible program. Start by working a lot with a relaxation tape to develop skills. Use the “brief relaxation response” frequently during a day and before going to sleep. Try any or all of the methods to deal with your disturbing thoughts.